The primary objective of this study is to compare the effectiveness of two "alternative" therapies (traditional Chinese acupuncture and therapeutic massage) for chronic low back pain with each other arid with the use of relatively inexpensive self-care educational materials. Three hundred enrollees of a large health maintenance organization (HMO) in Washington State will be randomized to receive either acupuncture (n=l00), massage (n=l00) or a book and videotape emphasizing self- management strategies for chronic back pain (n=l00). HMO enrollees with low back pain that has persisted at least 6 weeks (with or without sciatica) and who are between 20 and 70 years of age will be eligible. Exclusion criteria include: heart pacemakers, clotting disorders or on anticoagulant therapy, evidence of severe or progressive neurologic deficits, recent history of vertebral fractures, serious comorbid conditions, inability to speak or read English, and acupuncture or massage treatment for low back pain within the past year. Back pain treatment protocols recently developed by national acupuncture and massage therapy associations will be used. The treatments will be provided by licensed acupuncturists and massage therapists nominated by the Acupuncture Association of Washington and the Washington chapter of the American Massage Therapy Association, respectively. The number of treatments will be limited to a maximum of 12 to be provided over a maximum of 6 weeks. The primary outcome measures are: symptom relief, improved function, decreased disability and use of health services for back pain. Patient satisfaction and adverse reactions to treatment will also be measured. Outcomes will be measured 3, 6, 12 and 52 weeks after randomization. Unlike previous studies of alternative therapies for back pain, this study will evaluate the outcomes of greatest concern to patients (pain and function) and to health care systems (satisfaction and costs) in a real world setting. The findings of this study will provide guidance to health care providers, insurers and patients who want to know about the relative benefits and costs of alternative treatments for common problems such as back pain.